| NPI | 1861655722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LAVENDER SHELLEY Owner 7709-433-6290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: GA 033030181) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |